The Pre-Participation Physical Examination Chapter 6 The Pre-Participation Physical Examination

Objectives Upon completion of this chapter, you should be able to: Discuss the needs and overall goals of the pre-participation physical examination Distinguish between office-based and station-based exams List the important components of the pre-participation physical examination

Objectives (cont’d.) Upon completion of this chapter, you should be able to (cont’d.): Describe the clearance process for athletic examinations Discuss confidentiality concerns with recordkeeping

The Pre-Participation Physical Examination (PPE) Originally consisted of a short physical, often less than five minutes Today, it can be a comprehensive assessment of an athlete’s overall health and ability to perform Goal is to maintain health and safety of the athlete

Goals of the PPE Determine general health Disclose defects that may limit participation Detect conditions that may predispose to injury Determine optimal level of performance Fulfill legal and insurance requirements Provision of opportunities to compete for those with health conditions that may preclude blanket approval (ie. Athlete with diabetes can still participate, but needs access to medical services and may have to take special precautions

The PPE (cont’d.) Timing Should take place at least six weeks prior to the beginning of the athlete's sport season End of school year through mid-summer Any athlete rehabilitating over the summer must be reevaluated In Texas, must be completed at the beginning of the year due to off season workouts Most other states don’t have year round athletics, therefore no offseason

The PPE (cont’d.) Station-based PPE Examination by several different specialists Each responsible for one aspect Includes medical history and basic measurements of blood pressure, height, weight, and eyesight

The PPE (cont’d.) Station-based PPE (cont’d.) Specialists often include: Family physicians Orthopedic specialists Physical therapists Athletic trainers Podiatrists Pediatrician

The PPE (cont’d.) Station-based PPE (cont’d.) Advantages: Low cost Athlete will see several different sports medicine specialists throughout the exam process Disadvantages: Difficulty of recruiting volunteer physicians Finding a facility

The PPE (cont’d.) Office-based PPE Traditional doctor’s office Family physician usually has patient's complete medical history as a basis Quiet setting

Components of the PPE Medical history is the cornerstone Identifies about 75% of problems affecting athletes Recommended baseline: Medical conditions and diseases Surgeries and hospitalizations Medications Allergies

Components of the PPE (cont’d.) Recommended baseline (cont’d.): Immunization status Menstrual history Pulmonary status Neurological status Musculoskeletal status Injuries or illness since last exam

Components of the PPE (cont’d.) Standard components: Height Weight Pulse Blood pressure Eyes, ear/nose/throat, heart, abdomen, genitalia (males only), skin, and musculoskeletal

Clearance for Participation in Sports Three categories: Unrestricted clearance Clearance after completion of further evaluation or rehabilitation No clearance for certain types of sports or for all sports

Clearance for Participation in Sports When abnormality found, must consider: Does it place athlete at increased risk of injury? Is another participant at risk of injury because of the problem? Can the athlete safely participate with treatment? Can limited participation be allowed while treatment is being completed? If clearance denied for only certain sports, what activities can they safely participate in?

Clearance for Participation in Sports (cont’d.) Sports are classified based on degree or level of contact and strenuousness Contact or collision sports High risk of traumatic injury Limited contact sports Some risk of traumatic injury Noncontact sports Low risk as a result of force

Recordkeeping Managing resulting information is crucial Information must be made available to coaches, trainers, and the athletic director All information contained on the PPE form must be kept strictly confidential Secured in the office or under lock and key Should be kept for a minimum of seven years

Conclusion The PPE has evolved to become a comprehensive approach to medical assessment Can be either office-based or station-based Determining clearance is the most important PPE result The ultimate goal of the PPE is to allow athletes to compete safely